Lifestyle and Dietary Determinants of Peptic Ulcer Occurrence Among Adults in Kailahun Town, Sierra Leone

Abstract

Background Peptic ulcer disease (PUD) remains a significant public health concern in low- and middle-income countries (LMICs), with lifestyle and dietary behaviours recognized as critical modifiable determinants. Despite clinical evidence of a high burden in Sierra Leone, limited empirical data exist on the behavioural and nutritional factors driving PUD occurrence, particularly in rural underserved settings such as Kailahun Town. Objectives To identify lifestyle and dietary determinants of PUD occurrence; to assess dietary practices, including meal frequency and food type; and to analyse the association between identified behavioural and nutritional factors and PUD among adults in Kailahun Town. Methods A cross-sectional descriptive study was conducted among 154 purposively sampled adults with confirmed PUD diagnoses in Luawa Chiefdom. Structured interviewer-administered questionnaires were deployed via KoBoToolbox. Data were analysed using SPSS version 26 and R version 4.5.1. Descriptive statistics, chi-square tests, and binary logistic regression were performed. Statistical significance was set at p < 0.05. Results The sample was predominantly male (70.8%) with high educational attainment (66.2% tertiary). Frequent NSAID use (77.9%), alcohol consumption (55.8%), and smoking (23.4%) were the principal lifestyle risk factors. Bivariate analysis confirmed significant associations between PUD and alcohol consumption (χ² = 28.64, p < 0.001), smoking (χ² = 12.87, p < 0.001), and NSAID use (χ² = 4.92, p = 0.027). Logistic regression analysis identified alcohol consumption (AOR = 7.69, 95% CI: 3.25–18.20), smoking (AOR = 7.03, 95% CI: 2.54–19.42), and NSAID use (AOR = 2.41, 95% CI: 1.12–5.21) as independent predictors of PUD occurrence. The model explained 29% of the variance in PUD occurrence (Nagelkerke R² = 0.29). Conclusion Alcohol consumption, smoking, and unsupervised NSAID use are the dominant modifiable determinants of PUD in Kailahun Town. These findings underscore the urgent need for culturally tailored public health interventions targeting behavioural risk factors alongside dietary improvement strategies.